Botulinum toksin u liječenju migrene

master's thesis

• Title (english): Botulinum toxin in the treatment of migraine
• Author: Dora Toth
• Mentor: Lidija Bach-Rojecky (mentor)
• Committee member: Lidija Bach-Rojecky (predsjednik povjerenstva)
• Committee member: Petra Turčić (član povjerenstva)
• Committee member: Iva Mucalo (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Department of pharmacology); Zagreb
• Defense date and country: 2022-07-18, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Migrena je kompleksni poremećaj središnjeg živčanog sustava opisan kao rekurentna, epizodična ili kronična glavobolja koja pogađa veliki dio svjetske populacije. Specifična manifestacija: visok intenzitet boli, preosjetljivost na svijetlo i zvuk, mučnina, povraćanje i trajanje napadaja do 72 h dovodi do nefunkcionalnosti pacijenata, a time negativno utječe i na kvalitetu života. Terapiju migrene čine lijekovi koji inhibiraju lučenje peptida i medijatora upale, vazodilataciju, sintezu prostaglandina, ekscitaciju trigeminalnog živca ili centar za povraćanje u produljenoj moždini. BoNT-A je kao analgetik posebnih svojstava (dugo djelovanje, minimalne nuspojave, smanjuje ili u potpunosti uklanja bol, smanjuje broj dana u mjesecu s glavoboljom) idealan za liječenje kronične migrene, a dodatna prednost mu je što u dozama koje se koriste nema sistemske apsorpcije pa tako ni sistemskih nuspojava. Velik broj studija potvrdio je njegovu učinkovitost na temelju čega je dobio odobrenje za ovu indikaciju. Kriteriji za terapiju BoNT-A su: više od 15 napadaja mjesečno u trajanju od 4 ili više sati te nedjelotvornost prve i druge linije liječenja migrene. Toksin se primjenjuje u obliku injekcija na 40 mjesta na području glave i vrata svaka 3 mjeseca. U budućnosti je potrebno standardizirati postupke unutar studija, validirati metode mjerenja rezultata eksperimenata i dizajnirati formulaciju BoNT-A koja bi ljudima bila prihvatljivija za primjenu. Time bi se povećao broj ljudi koji bi primjenjivali BoNT-A za liječenje migrene i drugih bolnih poremećaja te proširio dijapazon potencijalnih indikacija za koje još nije dobio odobrenje.

Abstract (english)

Migraine is a complex disorder of central nerve system described as recurrent, episodic or chronic headache that affects large number of world population. Specific manifestation: high pain intensity, hypersensitivity to light and sound, nausea, vomiting and duration of attack up to 72 hours leads to disfunctionality of patients, a thus negatively affects quality of life. Migraine therapy consists of medications that inhibit secretion of peptides and inflammatory mediators, vasodilatation, prostaglandin synthesis, trigeminal nerve excitation or vomiting center in medulla oblongata. BoNT-A is, as analgesic with special properties (long duration, minimal side effects, reduces or removes pain completely, reduces number of days per month with headache) ideal for treating chronic migraine and his additional adventage is that he doesn't have systemic absorption in used doses, thus doesn't have systemic side effects. Large number od studies confirmed his efficiency on the basis of which he received approval for this indication. Criteria for BoNT-A therapy are: more than 15 attacks in duration of 4 or more hours and inefficiency of first and second migraine treatment. Toxin is administered in form of injections at 40 locations in head and neck region every 3 months. In the future is necessary to standardize procedure within studies, validate measurements of experimental results and design formulation of BoNT-A that would be more acceptable for application in humans. With that, number of people using BoNT-A for migraine and other pain disorders treatment would increase and diapason of potential indications, for which he didn't receive approval, would expand.

• Keywords: migrena; botulinum toksin tip A; kliničke studije; glavobolja; bol; akutni napadaj; animalni modeli; kronična migrena
• Keywords (english): migraine; botulinum toxin type A; clinical studies; headache; pain; acute attack; animal models; chronic migraine
• Language: croatian
• URN:NBN: urn:nbn:hr:163:191501
• Study programme: Title: Pharmacy; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: magistar/magistra farmacije (magistar/magistra farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-07-20 07:50:40